Grant: Project Grant - PA: Patient-Oriented Research: Early-Career Investigator

The rising trend in non-communicable diseases (NCDs), such as endocrine, cardiac, and respiratory conditions, is a public health priority that is affecting those of reproductive age, including women during pregnancy. It is estimated that over 10% of pregnant women in Ontario have an NCD that, if unmonitored, can lead to severe maternal morbidity and mortality. The Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends that women with NCDs consult a specialist in the preconception, during pregnancy, and postpartum periods, in addition to routine prenatal care, however there is little information on actual care practices in the Canada. The CONNECT Project is a multi-method study using population-level administrative health data combined with individual patient-level qualitative narratives to evaluate current health care for women with NCDs navigating pregnancy. It focuses on six NCDs that represent specific body systems, specialists, and ICES validated derived population-level cohorts, and include: 1) Gastrointestinal (Crohn's & Colitis); 2) Cardiovascular (hypertension); 3) Respiratory (asthma); 4) Autoimmune (rheumatoid arthritis); 5) Renal (kidney disease); and 6) Endocrine (diabetes). It will use health data from the Ontario Birth Registry (BORN Ontario) and administrative databases held at ICES to investigate connection to specialist care during pre-conception, pregnancy, and postpartum, including inter-conception care. A Clinical Working Group and Patient Engagement Group are integrated throughout the project to identify the most clinically relevant indicators for each NCD and the equally important voices of patients, who are experts in living day-to-day with an NCD. This study is designed to inform clinical guidelines and is supported by the SOGC, American Gynecological and Obstetrical Society, Society for Perinatal and Pediatric Research, and locally the Monarch postnatal care Centre.